What is Rheumatology?

Rheumatology is the medical specialty focused on the diagnosis, monitoring, and treatment of rheumatic diseases, which are conditions that affect the joints, tendons, muscles, bones, and other systems. Many of these diseases are autoimmune, meaning the immune system itself attacks the body’s tissues, causing inflammation and damage.

1. Rheumatoid Arthritis: One of the most common rheumatic conditions is rheumatoid arthritis, a chronic autoimmune disease that causes inflammation and pain in the joints, often leading to stiffness and swelling. If not treated promptly, it can cause severe deformities and functional limitations. Treatment focuses on reducing inflammation and maintaining mobility through personalized medication and supportive interventions such as physiotherapy.

2. Psoriatic Arthritis: Psoriatic arthritis is a chronic inflammatory disease that primarily affects peripheral joints. It is a heterogeneous disease that can present with various clinical forms, affecting different parts of the musculoskeletal system. In addition to joints, it can affect tendons and the spine, causing pain, swelling, and stiffness. In advanced stages, it can lead to joint deformities and functional limitations if not treated early.

3. Ankylosing Spondylitis: Ankylosing spondylitis is a chronic inflammatory disease that primarily affects the spine, causing pain and stiffness, especially in the morning. Over time, it can lead to permanent limitation of mobility. Treatment focuses on maintaining flexibility and functionality of the spine, while medication is adjusted according to the severity of the disease.

4. Systemic Lupus Erythematosus: Systemic lupus erythematosus is a multisystem autoimmune disease that can affect the skin, joints, kidneys, and other organs. Patients exhibit various symptoms, such as fatigue, joint pain, rashes, and sensitivity to the sun. The therapeutic approach is formulated based on the affected organs, aiming to stabilize the disease and prevent complications.

5. Scleroderma: Scleroderma is characterized by thickening and hardening of the skin, while it can also affect internal organs, causing serious complications. Patients may present with Raynaud’s phenomenon, where fingers turn white and painful in the cold. Management of the disease requires careful medical monitoring and a combination of therapies to improve the quality of life of patients.

6. Polymyositis - Dermatomyositis: Polymyositis and dermatomyositis are inflammatory myopathies that cause muscle weakness and difficulty in movement, while dermatomyositis may be accompanied by characteristic skin rashes. Treatment aims to improve muscle strength and reduce inflammation through personalized medication and supportive care.

7. Vasculitis: Vasculitis refers to a group of autoimmune diseases that cause inflammation of blood vessels and are divided into small, medium, and large vessel vasculitis. Small vessel vasculitis, such as ANCA-positive vasculitis (granulomatosis with polyangiitis, microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis), primarily affects the kidneys, lungs, and skin. Medium vessel vasculitis, such as Kawasaki disease and polyarteritis nodosa, can affect the heart, nervous system, and gastrointestinal tract. Large vessel vasculitis, such as giant cell arteritis and Takayasu arteritis, affects large arteries, such as the aorta and its branches, causing ischemic symptoms. Patients may experience fatigue, fever, rashes, muscle pain, or organ complications, depending on the type of vasculitis. Treatment is tailored to each case and includes corticosteroids and immunosuppressive agents to control inflammation and prevent serious complications.

8. Osteoarthritis: Osteoarthritis is the most common degenerative joint disease, caused by the gradual wear of articular cartilage. Patients typically experience pain, stiffness, and reduced mobility, especially in the knees, hips, and spine. Treatment focuses on pain management with analgesics and anti-inflammatory medications, enhancing muscle support through physiotherapy, and in advanced cases, surgical restoration with total joint replacement.

9. Osteoporosis: Osteoporosis is a skeletal disorder characterized by low bone density and increased risk of fractures. It is more common in women after menopause and in the elderly. Diagnosis is made by measuring bone density, while treatment includes the administration of calcium and vitamin D supplements, medications to increase bone mass, and exercise programs to improve balance and muscle strengthening.

10. Polymyalgia Rheumatica: Polymyalgia rheumatica is an inflammatory disease that mainly affects people over 50 years of age and is characterized by pain and stiffness in the shoulders, neck, and hips. Symptoms are more intense in the morning and may be accompanied by fatigue and low-grade fever. Treatment is based on low doses of corticosteroids, which usually have an immediate and positive response.

11. Fibromyalgia: Fibromyalgia is a chronic syndrome characterized by widespread musculoskeletal pain, fatigue, and sleep disturbances. Despite the fact that it does not cause inflammatory lesions, it significantly affects the quality of life of patients. Treatment includes a combination of pharmacological and non-pharmacological approaches, such as analgesics, physiotherapy, and lifestyle changes.

12. Rare Rheumatic Diseases: There are rare rheumatic diseases, such as Behçet’s disease, Sjögren’s syndrome, and mixed connective tissue disease, which can affect multiple organs and systems. These conditions require personalized diagnostic approaches and treatment tailored to the needs of each patient.

Rheumatic diseases are chronic and require continuous monitoring by a specialized rheumatologist. Early diagnosis and appropriate treatment can significantly improve the quality of life of patients, minimizing the effects of the disease and maintaining the functionality of affected joints and organs.